Immune Thrombocytopenia Purpura in an Acute Hepatitis C Patient with Pegylated Interferon α-2b Therapy: Report of a Case

急性C型肝炎病人接受長效型干擾素治療後引起之免疫性血小板缺乏紫斑症：一病例報告

吳毅晉(I-Chin Wu) ； 張定宗(Ting-Tsung Chang) ； 鄭斌男(Pin-Nan Cheng)

《臺灣消化醫學雜誌》 26卷2期 (2009/06) Pp. 188-194

https://doi.org/10.6557/GJT.200906_26(2).0007

摘要

長效型干擾素合併ribavirin是目前對於慢性C型肝炎的標準治療。骨髓抑制導致的輕度到中度血小板低下是干擾素治療常見的副作用。在極少數的情形下，因周邊血小板耗損引起的免疫性血小板缺乏紫斑症可以導致嚴重的血小板低下。一位68歲的男性因爲發燒3週住院，經過一連串的檢查後診斷爲急性C型肝炎。爲清除C型肝炎病毒，他開始接受長效型干擾素合併ribavirin的治療，但在接受長效型干擾素後隔天發生嚴重的血小板低下。隨後藉由病史及實驗室檢查診斷爲長效型干擾素引發的免疫性血小板缺乏紫斑症，病人也在停用長效型干擾素及接受靜脈注射類固醇後很快恢復。醫師們應該要知道免疫性血小板缺乏紫斑症可以在長效型干擾素治療後很快的發生。

關鍵字

免疫性血小板缺乏紫斑症 ； 長效型干擾素 ； C型肝炎

並列摘要

Pegylated interferon-α plus ribavirin is currently the standard treatment for chronic hepatitis C. Mild to moderate thrombocytopenia caused by direct bone marrow suppression is a common side effect of interferon-α. In rare instances, severe thrombocytopenia can occur through the development of immune thrombocytopenia purpura with peripheral consumption of platelets. A 68-year-old male patient suffered from intermittent fever for three weeks. Acute hepatitis C was diagnosed after serial examinations. To eradicate hepatitis C virus, he received pegylated interferon α-2b and ribavirin combination therapy. The patient developed severe thrombocytopenia on the next day after pegylated interferon α-2b therapy. Interferon α-2b induced immune thrombocytopenia purpura was diagnosed by history and laboratory examinations. The patient recovered rapidly after withdrawal of pegylated interferon and receiving parenteral methylprednisolone. Physicians should be aware that immune thrombocytopenia purpura can occur soon after the administration of pegylated interferon-α.

並列關鍵字

immune thrombocytopenia purpura ； pegylated interferon ； hepatitis C